Diltiazem and metoprolol

Common Questions and Answers about Diltiazem and metoprolol

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My friend Flycaster is right. Why the switch at all? The Metoprolol is a beta bocker and the Diltiazem is a calcium channel blocker, so I would have to wonder why the switch. The beta blocker would improve blood flow, while the calcium channel blocker helps the heart ryhthm and/or heart rate.

My EP doctor is changing me from 100mg metoprolol xl to 120mg diltiazem for svt. I have been on metoprolol xl for at least 10 yrs and I am still having episodes of flip flops so we talked about changing medication to see if it helps. He said I could just stop taking the metoprolol and start on the new. Would I not have any withdrawl off the metoprolol xl? Does diltiazem help with anxiety also? Is diltiazem better for svt flip flops?

Atenolol can and often does have an additive affect when taken along with other beta blocking meds.
In my case, even though the Atenolol was only 25 mg, it was enough to cause several heart pauses (flatlines) of 3 to 4 second durations detected via an event recorder.
Regarding the interaction between Diltiazem and Tambocor, this is from drugs.com:
"Using diltiazem together with flecainide can increase the effects of either medication.

That is a serious antiarrhythmic, and after taking it, I had a very bad episode of SVT that was extremely had to convert. So I went back on Metoprololand began examining the electrophysiology procedure with ablation as an alternate treatment.

It's so interesting how we all react differently to these drugs.
For me, I was on metoprolol (only 12.5 mg) and had vivid, horrible night terrors and had to come off after 3 days.
Then (like you) I went on to diltiazem for 3 days. While on this, I had some insomnia and almost felt like I was having a stroke at one point. I had facial flushing and weird body sensations. Came off that one.
Now I'm on atenolol (25 mg) and it puts me to SLEEP very easily.

I just got back from my internist. She is truly a wonderful compasionate doctor that really wants to help keep me as healthy as possible. Of course all my blood tests came back perfect except that I was low in Vitamin D.
I was actualy hoping something was off so that I had a reason for the increase in these damn episodic pvc's that have been lasting for hours at a time. She wants me to try a channel blocker called diltiazem on an "as needed" basis.

I have suffered with taking diltiazem(180 mg ER) AND metoprolol (50 mg ER) for atril fibrillation for the past two and a half years. The side effects have been debilitating.. Both drugs have the same side effects and together and one or the other or both create what I can only describe as chaotic turbulence in my chest and pain in my left arm when the second drug kicks in.. My cardiolgist now wants me to add a blood thinner (xarelto) to my meds menu.

I was on a daily dose of the beta blocker (Metoprolol) for near lifetime SVT. My GP doc said to carry a small supply, and chew an extra 50mg when my SVT occurred (generally 4 to 5 times per month) as it MIGHT help. When I saw my cardiologist I mentioned this to him. His comment was (with a slight roll of the eyes) "It doesn't work that way".

Now I am in the UK and I tell a two different pharmacies my problem. I think metropolol anddiltiazem should not be combined they are contraindicated and make me feel awful. I had no afib symptoms before these pills. They make me feel worse than I ever felt in my life. Both pharmacists looked up their book on British National Formulary and said one word "asystole" that is what their books told them was the danger of combining these drugs.
No American ever dared to tell me this.

So with your sick sinus syndrome, the doc may want to hold off the Diltiazem till you get the pacemaker. Keeping your rate up and steady is pretty important.
Is your Raynauds primary or secondary? Has the doctor mentioned putting you back on the med after the pacemaker is installed? Honestly, you will feel better once you have it and your heart rate does what it's supposed to do. Stay in touch and let us know how it goes tomorrow. Remember - don't lift your arm.

When they were trying to control rate with JUST beta blockers... I took 200 of propranolol and 300 of metoprololand occasional 100 of labetalol here and there. It helped but it worked a LOT better when other classes of drugs were added. Since the point is to slow you down, it generally SLOWS you down. When I was on THAT much, I felt like I was nailed to the couch. Now, instead I take coreg as a beta blocker and diltiazem, and flecainide and lisinopril.

Research on the web says that Atenolol is much longer lasting than Metoprololand suggests that Metoprolol Tartrate has to be taken twice a day... Atenolol only once ! Strangle, again, my Cardiologist who issued a prescription for Atenolol upon my request to be allowed to try it is for 25 mg twice a day.

I was put on sotolol for atrial fibliration. Cardiologist switched sotolol to metoprololand now I seem to be having a reaction from meds, hives. Cardiologist wants me to switch metoprolol for diltiazem but I read that suddenly stopping metoprolol could cause a thyroid storm. I've already been through this and do not want to do it again. Is diltiazem safe? I did not even know until recently that metoprolol was also a med for thyroid.

The first in two years landed me in the Hospital. My meds were changed from Metoprolol to Diltiazem 360 mg per day and Fleconade 50 mg 2x per day plus Warfarin. The Metoprolol 25mcg 1 x daily has been making me wheeze for the past four years, but no one ever thought to change the meds. I have been on this new med protocol for 1.5 weeks. I just started the Fleconide and Warfarin three days ago.
My question is I need to loose 45 pounds asap.

Ask your doctor about beta-blockers (like propanolol, etc) that don't cause bronchospasm -- such as metoprolol. Other options would be diltiazem or verapamil (calcium blockers) to slow the heart rate. Sometimes we need to use xanax-like medications for anxiety until the thyroid is controlled.

I have been taking metoprololanddiltiazem for sixteen months and initially the medications brought the SVTs under control. Fourteen months ago I started coughing blood and experiencing chest congestion. This took my attention off any heart issues and sent me on a long search for the cause of the bleeding. After many tests and visits with various specialists I never did get the answer. The bleeding resolved itself after 10 months (last October) and has not reappeared.

, metoprolol, with newly diagnosed severe COPD, what is the appropriate recommendation for BB therapy. Should patient be tapered and switched to diltiazem/verapamil or continued? If continued, what about if they are taking high dose per day of metoprolol, ie., >=100mg daily.

75 mg of Bystolic over the course of a month would cause heart racing, breathing problems and chest discomfort? My doc. said it was such a low dose, that if I didn't like it, I could just probably quit without worrying about side effects. I didn't want to chance it and have been cutting in 1/2 the dose every 7 days. I had an a few breathing episodes and a heart racing/flutter that sent me running to the ER last night. Nothing found...

I have had the symptoms of psvt since I was 16 but only got diagnosed with it about 7 years ago. I've been taking Diltiazem 120mg on a daily basis ever since and recently started taking Metoprolol 25mg also on a daily basis( diltiazem in the a.m., metoprolol in the p.m.). I went to the dentist today for an abcess wisdom tooth, and they suggested I get dentures on the top.

I think you have to weigh the significant risks involving ablation and the location of your accessory pathway vs. drug therapy and living with your condition. How often do your events occur? Are you able to convert them yourself by some means; Valsalva, etc.? At 30 years old, time is on your side. Perhaps a new technique in the next decade will make your particular situation less risky.
Verapamil is a serious, Class IV anti arrhythmic that is indicated for SVT.

Your heart rate being slow is reflective of two of the medications that you are on that block the atrioventricular node (conduction system of the heart); diltiazemandmetoprolol. Neither of those medications are good at controlling blood pressure. A better beta blocker to use rather than metoprolol is carvedilol as it acts to lower blood pressure through a different mechanism than metoprolol.

PULSE RATE IS 43bpm. I SEE A DOCTOR WHOM PRESCRIBED DILTIAZEM 90mg X3 A DAY,METOPROLOL TARTRATE 25mg X2 A DAY.HCTZ 50mg X1. MY BP HAS BEEN AS HIGH AS 220/140. I HAVE NAUSEA, "BUGGY ITCHY" EYES. CAN'T FOCUS.

The CCB also seemed to reduce some of the fatigue I was experiencing from a high dose BB (was at 100 mg Metoprolol, now at 50 mg).
Then about a week to ten days ago I noticed my left ankle, and on inspection my right ankle and both feet were swollen. I did not have any pain and remain able to walk for normal daily duties. The swelling goes down considerably overnight, with my feet elevated to the normal sleeping position (not artificially elevated).

Because I have so many fun things going on in there (PAC's and PVC's daily and atrial tachy several times a week) they did put me on Diltiazem a couple weeks before the surgery to settle things down a bit. I don't think it was necessary but it made them happy. As long as the doctors and anesthesia person knows about your jumpy heart, they'll expect it and not panic. They'll be prepared.
Good luck with your surgery.

They just kept adding more and more meds until I fell over pulseless. Now I'm on coreg, flecainide, diltiazem, and lisinopril. I never have had high blood pressures and all these sometimes about tip me right over. If I don't take them though, my rate runs away. The ablations were only marginally successful. A pacemaker now prevents me from too slow side effects of the meds, but I have learned that hypotension can still be a problem.

I was prescribed metoprolol for reasons unrelated to my SVT. I was complaining of awakening nightly to a pounding and elevated sinus rate. The metoprolol helped my rate, but it turned out that I had severe sleep apnea, and that's why it was high. I found that it did absolutely nothing to prevent SVT. The GP's response was to increase the dosage and at one point I was on 200mg daily. It's effect lowered my HR to the low 50's, and my heart was slow to respond to demands.

I have a follow up visit with my Cardiologist's Physician Assistant (PA) concerning my change about 3 weeks ago from 100 (or more) Metoprolol a day to taking 50 mg Metoprololand 240 mg Diltiazem XR (Diltia XT) a day. The former is Beta Blocker (BB) and the latter a Calcium Channel Blocker (CCB). Both are long/extended/slow (whatever) release and are often prescribed for taking once every 24 hours.

Taking Diltiazem, Lisinopril, Aspirin and Ranitidine as well. Have been having constant stomach and chest pains and the doctors are not able to find the cause- at least they don’t think it is a cardiac one./the chest pains/ My gastroenterologist suggested I stop taking Ranitidine and switch to Pantroprazole. I have read a lot about the interaction between Plavix and PPI’s but he thinks only Omeprazole have more effect on Plavix, not Pantoprazole.

http://www.medhelp.org/drugs/metoprolol/show/3810
http://www.medhelp.org/drugs/diltiazem/show/3734
Both (see above links) list the following as a serious side effect: "nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes)."
Hopefully you're not having low-grade fever and jaundice along with your abdominal pain and abnormal stools? I imagine your doc would've ruled this out already.

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